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Depressive symptoms, cognitive impairment, and all-cause mortality among REGARDS participants with heart failure.
Khodneva, Yulia; Ringel, Joanna Bryan; Rajan, Mangala; Goyal, Parag; Jackson, Elizabeth A; Sterling, Madeline R; Cherrington, Andrea; Oparil, Suzanne; Durant, Raegan; Safford, Monika M; Levitan, Emily B.
Affiliation
  • Khodneva Y; Department of Medicine, School of Medicine, University of Alabama at Birmingham, MT509H 1717 11th Avenue South, Birmingham, AL 35294-4410, USA.
  • Ringel JB; Division of Internal Medicine, Weill Cornell University, 530 East 70st Street, New York, NY 10021, USA.
  • Rajan M; Division of Internal Medicine, Weill Cornell University, 530 East 70st Street, New York, NY 10021, USA.
  • Goyal P; Division of Internal Medicine, Weill Cornell University, 530 East 70st Street, New York, NY 10021, USA.
  • Jackson EA; Division of Cardiology, Weill Cornell University, 530 East 70st Street, New York, NY 10021, USA.
  • Sterling MR; Department of Medicine, School of Medicine, University of Alabama at Birmingham, MT509H 1717 11th Avenue South, Birmingham, AL 35294-4410, USA.
  • Cherrington A; Division of Internal Medicine, Weill Cornell University, 530 East 70st Street, New York, NY 10021, USA.
  • Oparil S; Department of Medicine, School of Medicine, University of Alabama at Birmingham, MT509H 1717 11th Avenue South, Birmingham, AL 35294-4410, USA.
  • Durant R; Department of Medicine, School of Medicine, University of Alabama at Birmingham, MT509H 1717 11th Avenue South, Birmingham, AL 35294-4410, USA.
  • Safford MM; Department of Medicine, School of Medicine, University of Alabama at Birmingham, MT509H 1717 11th Avenue South, Birmingham, AL 35294-4410, USA.
  • Levitan EB; Division of Internal Medicine, Weill Cornell University, 530 East 70st Street, New York, NY 10021, USA.
Eur Heart J Open ; 2(5): oeac064, 2022 Sep.
Article in En | MEDLINE | ID: mdl-36330357
Aims: To ascertain whether depressive symptoms and cognitive impairment (CI) are associated with mortality among patients with heart failure (HF), adjusting for sociodemographic, comorbidities, and biomarkers. Methods and results: We utilized Medicare-linked data from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study, a biracial prospective ongoing cohort of 30 239 US community-dwelling adults, recruited in 2003-07. HF diagnosis was ascertained in claims analysis. Depressive symptoms were defined as a score ≥4 on the four-item Center for Epidemiological Studies-Depression scale. Cognitive impairment was defined as a score of ≤4 on the six-item screener that assessed three-item recall and orientation to year, month, and day of the week. Sequentially adjusted Cox proportional hazard models were used to estimate the risk of death. We analyzed 1059 REGARDS participants (mean age 73, 48%-African American) with HF; of those 146 (14%) reported depressive symptoms, 136 (13%) had CI and 31 (3%) had both. Over the median follow-up of 6.8 years (interquartile range, 3.4-10.3), 785 (74%) died. In the socio-demographics-adjusted model, CI was significantly associated with increased mortality, hazard ratio 1.24 (95% confidence interval 1.01-1.52), compared with persons with neither depressive symptoms nor CI, but this association was attenuated after further adjustment. Neither depressive symptoms alone nor their comorbidity with CI was associated with mortality. Risk factors of all-cause mortality included: low income, comorbidities, smoking, physical inactivity, and severity of HF. Conclusion: Depressive symptoms, CI, or their comorbidity was not associated with mortality in HF in this study. Treatment of HF in elderly needs to be tailored to cognitive status and includes focus on medical comorbidities.
Key words

Full text: 1 Collection: 01-internacional Database: MEDLINE Type of study: Diagnostic_studies / Prognostic_studies / Risk_factors_studies Language: En Journal: Eur Heart J Open Year: 2022 Document type: Article Affiliation country: United States Country of publication: United kingdom

Full text: 1 Collection: 01-internacional Database: MEDLINE Type of study: Diagnostic_studies / Prognostic_studies / Risk_factors_studies Language: En Journal: Eur Heart J Open Year: 2022 Document type: Article Affiliation country: United States Country of publication: United kingdom